Improv for Anxiety: Re-Wiring the Brain for Presence Through Play

Imagine that you’re sitting in a theatre. You’re watching an improv show — a performance where everything is made up on the spot (usually at the audience’s suggestion). The crowd is fully absorbed. The players are executing with brilliance: they are fully inhabiting their bodies and the stage; listening and responding with tact; and discovering entertaining bits of information as the scene unfolds. Everyone is fully immersed in the moment.

Suddenly you remember that you’re scheduled to meet with your boss at work tomorrow. Crap. I really don’t want to have this meeting. She’s going to scold me about that project. Your attention is pulled away from the performance. You miss a line that elicits an eruption of laughter in the crowd. You try to fix your attention back on the stage, but it keeps getting pulled back into worry. You notice that your heart is racing just thinking about tomorrow. And you’re sweating a little. You’re also on a date — and as you recognize this, you worry whether your date can pick up on your discomfort. Can he sense my nervousness? Does he notice that I’m sweating? Do my armpits smell now? Did I put deodorant in my purse? No, I ran out… I need to get more deodorant. I’ll make a note of it after the show… Should I do non-toxic deodorant? Yea, definitely non-toxic. Better for me, and the environment, right?!… The scene ends with raucous applause from the audience.

We all experience anxiety — times when we’re lost in thought, experience physiological tension or arousal, or avoid certain people, places, or behaviors that might elicit feelings of discomfort. Anxiety takes us out of the moment, as illustrated in the case above. I have been the person (more often than not) sitting in the improv show, movie, lecture, or other environment, and my mind takes me completely out of the moment. Exactly what they’re modeling on stage — being present, listening, allowing space for the unknown — is exactly what I’m not doing sitting in my chair.

Improv has so much to teach us about life. As an improv student for the past 5+ years, I can attest to the psychological and social benefits of this practice. As a clinical psychologist — and as someone who knows anxiety well, personally — I have taken a keen interest in how improv can be used to help people better manage anxiety. Anxiety has skyrocketed across the globe over the past couple years, partly (although not exclusively) due to the pandemic. It’s estimated that 30% of adults will meet criteria for an anxiety disorder at some point in their lives. But, honestly, who do you know that doesn’t struggle with anxiety? For some of us, it causes enough disruption in well-being and/or impairment in daily life to be considered a mental health disorder. For everyone else, it’s an annoying monkey on our back that affects our quality of life more than it needs to. We could all benefit from practical, powerful, accessible ways to better manage anxiety. I think that improv is a largely untapped tool that holds great potential for improving anxiety and psychosocial health, more broadly.

This article focuses on how improv can benefit anxiety. It covers:

A) The evolutionary origins and function of anxiety.

B) Research on the use of improv for anxiety.

C) The five mechanisms through which improv may improve anxiety:

1) Present-Moment Attention

2) Tolerance of Uncertainty

3) Exposure to Negative Evaluation

4) Cognitive Flexibility

5) Self-Kindness

The Origins and Purpose of Anxiety

Remember that story you imagined at the beginning of this article? You were able to project yourself into a non-existent situation because of the special powers of your brain. And now, you are also able to remember projecting yourself into that non-existent situation, again because of the powers of your mind.

The human brain has a unique capacity to imagine. We can extend our “selves” outside this moment to remember the past and forecast the future. This served an evolutionary purpose for our ancestors. Because of their ability to remember pleasant and unpleasant experiences from the past, and plan for a future that could increase the likelihood of pleasure and survival (and minimize pain/suffering/death), our ancestors were able to gain more control over their environments. They could more readily protect themselves from danger and increase the likelihood of satisfying innate needs — finding food or mates, for example.

Obviously, us modern homo sapiens still contain the hardware of our ancestors; we possess the power to remember the past and imagine a future. Bound up with this hardware is humans’ unique capacity for language, which enables elaborate and complex imaginings to take place in the mind. We can literally imagine almost anything — which is not good, so long as our brain goes down the alleyways of fear-invoking possible futures.

This is what anxiety does: it imagines future scenarios that elicit a sense of needing to act or gain some control, in effort to protect ourselves from something bad happening. In a modern world where so many things could go wrong — we no longer have to worry about being attacked by a Lion, but we do worry about being attacked by our co-worker Lisa, and doing Laundry, and the fact that I have money on the Lakers tonight — it’s no wonder that we always feel anxious. There are endless things to worry about. In a world that is increasingly more complex and fast-paced, it makes sense that anxiety is on the rise.

Research on Improv for Anxiety

There is a small but growing collection of research on improv for anxiety. Therapeutic applications of improv for anxiety have existed for several years (albeit in tiny corners of the improv world, for example through Second City), yet a robust research literature still lags. Scientists have slowly begun to study such programs, which sometimes add elements of cognitive-behavioral therapy (CBT) to traditional improv exercises. One study examined a ten-week, school-based improv program for adolescents. They found reductions in social anxiety for adolescents with high baseline levels of social anxiety. A pilot study with adults found improvements in anxiety, depression, and self-esteem after a short intervention of improv exercises. Another study looked at improv as an intervention for youth and young adults with autism. They found improvements in feelings of nervousness and reductions in feelings of exclusion in this sample. Finally, one study had participants engage in 20 minutes of improv exercises and found that this brief intervention improved divergent thinking and uncertainty tolerance — two important variables in anxiety (see more in the section below). This review of studies is not exhaustive, but highlights some of the preliminary work being done in this field.

How Does Improv Help with Anxiety?

Improv may exert its effects on anxiety through five psychological mechanisms. There may be more mechanisms, or ways to parse them, but hopefully this will provide a general framework.

Present-Moment Awareness

Improv, almost by definition, is about being in the present moment. In order to “yes and” your scene partner(s), you have to actually be present to observe them. If you’re off thinking about something else in your head, you’re not going to be able to respond appropriately, if at all; if you’re not present, what you say will miss the mark (and 9/10 times will not be funny). So, integral to improv is listening and responding. This requires present-moment attention.

The ability to focus our attention in the here-and-now is often referred to as mindfulness. Indeed, we can think about improv as a “group mindfulness” practice. Instead of going inward and focusing on the breath, we direct our attention to our partners and what’s happening around us. Just like in meditation, when we notice the mind wandering in improv, we can try to bring our focus back to the present.

Anxiety keeps us out of the present. It keeps us stuck in our heads, ruminating about the past and future. One of the underlying components of anxiety — and in fact, most mental illnesses — is the inability to purposefully direct our attention. On one level, this is a process problem: instead of focusing on the here-and-now, we are continuously swept up in a whirlwind of anxious thoughts (what if THIS happens? And then what if THAT happens because THIS happened? Oh my god… what would that mean about ME?! Wait… why am I worrying so much? Am I a worrier?). On another level, anxiety is a content problem: our attention is directed to “what’s wrong” in a situation versus “what’s right” (this is called the negativity bias). On both levels, our minds benefit from having more control and flexibility over our attention. This is the muscle that meditation trains. Improv is another way of flexing this muscle.

Because of the social pressures to be fully engaged, or due to the inherent joy of playing with others, or both, improv forces present-moment attention in a way that meditation does not. Improv is like going to a gym where everyone is staring at you and shouting, “you can do this!!!!” (kindly, of course… Why is it that improv people are always so nice?). Meditation is like going to a gym where everyone is exercising alone. The benefit of the former is that you get in shape quickly and form social relationships. The benefit of the latter is that you gain more awareness of your inner experiences and improve your relationship with yourself. Both have their utility.

Tolerance of Uncertainty

At the heart of anxiety is what is called “uncertainty tolerance.” This is just what it sounds like: the inability to tolerate uncertainty.

Anxiety wants to “know.” It wants to know what is going to happen later today, tomorrow, next month, and next year. To know what that other person is thinking about us. To know whether this relationship is going to last, or whether I am with the “right” person. These manifest in various ways in different anxiety disorders (e.g., Social Anxiety, OCD), but the need to “know” is common across all forms of anxiety. It is a way of trying to predict and control the future. As long as we can do that, we can avoid pain (or so we think). While this strategy can sometimes be successful — we gather some relevant information about the future — oftentimes it doesn’t work; and even when it does, we are still miserable. We can know everything and be in control of everything, but where is the spontaneity in that? This leads to living a rigid and fearful life. At the expense of happiness and joy, we gain control. It’s a tradeoff that often happens unconsciously (no one really wants to be miserable, but our brains dupe us into these patterns).

Improv forces us to be in the unknown. We don’t know what is going to happen later in the scene, let alone one second from now. Improv thrusts us into a space where our ability to control and know are stripped from us (this sounds evil, but it’s kind in the sense that it helps us grow). This is why improv, itself, can be anxiety provoking. You want me to do what?! Stand up in front of a bunch of people, without knowing what is going to happen, and without being in control of what others say and do?

The gold-standard treatment for anxiety is called “exposure.” This just means that we expose ourselves to what we’re afraid of. In some cases of anxiety, it’s pretty straightforward: you’re afraid of snakes? Let’s (slowly) put you in front of some snakes (or pictures of snakes). You’re afraid of speaking up in class? Let’s devise some sequential steps to practice this. In other cases, exposure is a little more complex. For example, someone with OCD who has a habit of “checking” to make sure the door is locked (i.e., knowing) might expose themselves to not checking (i.e., not knowing) if the door is locked. Someone with Generalized Anxiety Disorder who constantly worries about the future (i.e., knowing) might try to let go of these worries and focus on something else (i.e., not knowing). Anxiety thrives on control. One way to control is by knowing. Exposure therapy helps us break these habits. Over time, this results in less anxiety.

Improv is an exposure to the unknown. It’s not only about exposing ourselves to potential negative social evaluation (see below); it’s much deeper than that. Improv taps into the circuitry of the brain that regulates either a) approach or b) avoidance of the unknown. This is one of the most fundamental things we can do to grow. While the known keeps us safe, the unknown is where we grow. If we hide in the known, our life remains small. If we can learn to lean into the unknown, life expands.

Exposure to Negative Social Evaluation

This mechanism is fairly obvious. Performing (or playing games) in front of others inherently triggers fear of negative social evaluation. The more we expose ourselves to this, the less scary and poignant social evaluation becomes.

At some point, we will “mess up” in an improv scene or game. We can learn to be more comfortable when this happens. Hopefully, this translates into our everyday lives. We might be willing to take more risks in front of others. We might feel less of a sting if, and when, others judge us. We might dare to be more authentically ourselves.

Cognitive Flexibility

People with anxiety are notoriously inflexible. They want to do things this way; they want plans to go just as planned; they may be less willing to try new things or “go with the flow.” Research shows that cognitive flexibility is central to psychological well-being.

Improv teaches us to be flexible. As soon as we think we “know” what direction a scene is headed, something unexpected happens. My scene partner calls me “daddy” when I thought we were just friends; all of a sudden, I am in a parenting role with my scene partner (or perhaps entering into a kinky relationship). Didn’t see that coming, but I’m going to “yes and” and roll with it.

Both scene work and improv games teach us to think quickly and think on our feet. We often end up tapping into knowledge or creativity that we never knew existed. For example, someone ends up playing a Marine Biologist in a scene and (without thinking about it) rattles off some facts about whales — maybe something embedded deep in your psyche from biology class that you wouldn’t have otherwise consciously remembered. Or, maybe you just made up these “facts.” The made-up stuff is often the best. In one improv game, for example, players quickly shout out names of non-existent [car models, toothpaste brands, cereals, etc.], based on what “sounds like” it would be real (e.g., “smooth whites!”). Here we are tapping into the brain’s creativity and flexibility. We are being forced to think abstractly and make new connections. It allows us to practice breaking out of old, stale patterns of thinking and behavior.

Self-Kindness

Last, but not least, improv provides ample opportunities to practice self-kindness. We all live with an inner critic inside our minds. For those of us with anxiety, this critic may be even louder and more incessant. People who are “perfectionists,” for example, will look for opportunities to prove to themselves that they’re not good enough (“not good enough yet, I just need to do [x] a little bit more…!).

It is very hard to survive an improv class without a little self-kindness. We are going to say something “stupid.” We might say something that doesn’t make any sense. Or, in my case, we might not say anything at all and stand there like a deer in headlights.

Improv is a petri dish for the emergence of failure, and failure provides opportunities to meet ourselves with greater compassion.

Summary

Improv is a tool that can help train our mind to be more present, flexible, courageous, and tolerant of uncertainty. These skills are crucial for managing anxiety. An important component of absorbing these concepts, and putting them into action, is having the proper container: improv classes geared towards anxiety should provide proper education on anxiety, alongside a safe, supportive, and reliable space to experiment with these skills (both in and out of the class).

Matthew Goodman, Ph.D. is a Licensed Clinical Psychologist (PSY32423), consultant, and speaker. He has taught meditation for 10+ years to children and adults across a variety of settings (e.g., hospitals, clinics, companies). His Zen-prov! classes teach the skills of presence, self-compassion, courage, confidence, and joy through fun and interactive improv exercises. Dr. Goodman was previously Clinical Assistant Professor of Psychiatry and the Behavioral Sciences at the Keck School of Medicine of USC, where provided clinical care, teaching, and supervision, along with sitting on the Steering Committee for the Center for Mindfulness Science. He is the author of “Simple Stress-Reduction: Easy and Effective Practices for Kids, Teens, and Adults” and host of The Middle Way Podcast.